An Analysis of Long-Term Care and Primary Social Care Service Systems Through Community Participation in the Next Normal Era in Health Region 5

Abstract

          This mixed-methods study aimed to: 1) analyze the long-term care system, primary social care services, and community participation; and 2) examine the barriers and challenges in the provision of long-term care and primary social care services in communities within Health Region 5, Thailand. The study sample consisted of two groups. The qualitative group comprised 40 participants and was divided into three subgroups: 20 dependent older adults, 10 community leaders, and 10 healthcare personnel. The quantitative group included 330 participants and was also divided into three subgroups: 177 dependent older adults, 96 community leaders, and 57 healthcare personnel. The research instruments consisted of semi-structured interview guides and questionnaires. Data were analyzed using descriptive statistics and thematic analysis. The findings revealed that:
          The provision of primary long-term care services could be categorized into three major themes: 1) longterm care service delivery in the next normal era, 2) resource management, and 3) health system governance. Primary social care services, which are essential for promoting quality of life and social well-being, were classified into two categories: (1) primary social care in the next normal era and (2) social welfare services. Regarding community participation in long-term care service provision, the overall level of participation was moderate (M = 3.40, SD = 0.57). Among the dimensions assessed, participation in planning and decision-making demonstrated the highest mean score and was rated at a high level (M = 4.02, SD = 0.52). Major barriers to service implementation were identified in two areas. First, service delivery barriers included duplicated health information recording systems, delays in real-time data processing, and limited readiness for information technology adoption. Second, resource management barriers included shortages of healthcare workforce, insufficient budgets, and inadequate medical equipment.
          Therefore, the development of long-term care and social care services should emphasize the integration of information technology, effective resource management, and comprehensive data linkage across all levels of care. In addition, efforts should focus on enhancing awareness of social welfare rights and promoting active community participation in service provision to achieve sustainable community well-being